Provider Demographics
NPI:1053686063
Name:GERMANTOWN REPRODUCTIVE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:GERMANTOWN REPRODUCTIVE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:CARHART
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:301-353-9200
Mailing Address - Street 1:13233 EXECUTIVE PARK TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2648
Mailing Address - Country:US
Mailing Address - Phone:301-353-9200
Mailing Address - Fax:301-601-4318
Practice Address - Street 1:13233 EXECUTIVE PARK TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2648
Practice Address - Country:US
Practice Address - Phone:301-353-9200
Practice Address - Fax:301-601-4318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0071127208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEA65468Medicare UPIN